Sarcopenic Obesity in Metabolic and Bariatric Surgery: A Scoping Review

Area of Science:

• Obesity and Metabolic Surgery
• Geriatric Medicine
• Nutritional Science

Background:

• Sarcopenic obesity (SO), defined by excess adiposity and diminished muscle mass/function, poses risks in metabolic and bariatric surgery (MBS) patients.
• SO can develop post-MBS or worsen pre-existing conditions, leading to adverse health outcomes.
• Prevalence and impact of SO in the context of MBS require comprehensive understanding.

Purpose of the Study:

• To synthesize current literature on sarcopenic obesity in patients undergoing metabolic and bariatric surgery.
• To review diagnostic criteria, assessment methods, prevalence, incidence, and clinical outcomes associated with SO in MBS.
• To highlight the need for standardized diagnostic approaches and increased awareness of SO post-MBS.

Main Methods:

• Scoping review of existing literature on sarcopenic obesity and metabolic and bariatric surgery.
• Analysis of diagnostic criteria and assessment methodologies for SO.
• Investigation of SO prevalence (pre- and post-surgery) and incidence post-surgery.

Main Results:

• SO prevalence in MBS is highly variable, influenced by diagnostic criteria and assessment methods.
• Approximately one in four individuals exhibit SO both before and after MBS when appropriate criteria are used.
• SO is linked to reduced weight loss, poorer quality of life, increased gastric leak risk, and longer hospital stays.

Conclusions:

• Sarcopenic obesity is a significant concern in metabolic and bariatric surgery patients, necessitating targeted interventions.
• Standardization of SO diagnosis is urgently required to improve identification, facilitate comparisons, and guide clinical management.
• Increased awareness of post-MBS sarcopenic obesity, particularly in aging populations, is recommended for better patient outcomes.